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See detailConscious Experience and Psychological Consequences of Awake Craniotomy
Hejrati, N.; Spieler, D.; Samuel, Robin UL et al

in World Neurosurgery (2019)

Background Experiencing cranial surgery under awake conditions may expose patients to considerable psychological strain. Methods This study aimed to investigate the occurrence and course of psychological ... [more ▼]

Background Experiencing cranial surgery under awake conditions may expose patients to considerable psychological strain. Methods This study aimed to investigate the occurrence and course of psychological sequelae following awake craniotomy (AC) for brain tumors in a series of 20 patients using a broad, validated psychological assessment pre-, intra-, postoperatively and a standardized follow-up of 3 months. In addition, the association of the preoperative psychological condition (including, but not limited to, anxiety and fear) with perioperative pain perception and interference was assessed. Results AC did not induce any shift in the median levels of anxiety, depression, and stress symptoms already present prior to the procedure. Furthermore, anxiety and depression were all moderately to strongly associated over time (all p<0.05). Stress symptoms also correlated positively over all times of measurement. Stress three days after surgery was strongly associated with stress three months after surgery (p<0.001), while the correlation between pre- and immediate postoperative stress showed a statistical trend (p=0.07). Preoperative fear was not related to intraoperative pain, but to pain and its interference with daily activity on the third postoperative day (p<0.001 and p<0.01, respectively). Conclusion Postoperative psychological symptoms clearly correlated with their corresponding preoperative symptoms. Thus, mental health was not negatively affected by the awake craniotomy experience in our series. Intraoperative fear and pain were not related to the preoperative psychological condition. However, preoperative fear and anxiety were positively related with pain and its interference with daily activity in the immediate postoperative period [less ▲]

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See detailSexual Dysfunction After Good-Grade Aneurysmal Subarachnoid Hemorrhage
Epprecht, Lorenz; Messerli, Michael; Samuel, Robin UL et al

in World Neurosurgery (2018)

OBJECTIVE: To assess the consequences of aneurysmal subarachnoid hemorrhage (aSAH) on sexual pleasure in patients with an otherwise favorable neurologic outcome. METHODS: Anonymous, standardized ... [more ▼]

OBJECTIVE: To assess the consequences of aneurysmal subarachnoid hemorrhage (aSAH) on sexual pleasure in patients with an otherwise favorable neurologic outcome. METHODS: Anonymous, standardized questionnaires concerning sexual function, including the International Index of Erectile Function (IIEF), Female Sexual Function Index (FSFI), and a statement on subjective change in sexual pleasure after aSAH, were completed by 33 patients treated at the Cantonal Hospital St Gallen between 2005 and 2013. All had favorable neurologic outcomes (Glasgow Outcome Scale score 4 or 5). RESULTS: Ten patients (31.3%) reported a subjective worsening of sexual pleasure after aSAH. Sexual dysfunction according to FSFI criteria affected 9 of the 19 female patients (47.4%). All 19 women had a hypoactive sexual desire disorder. Erectile dysfunction was present in 7 of the 14 male patients (50%). Patients with World Federation of Neurosurgical Societies (WFNS) grade 2 aSAH were significantly more likely to report a subjective worsening of sexual experience after hemorrhage than those with WFNS grade 1. CONCLUSIONS: This is the first known evaluation of sexual health following aSAH with otherwise favorable neurological outcomes, and confirms that sexual dysfunction is common in this population. Sexual health should be explored during follow-up with these patients [less ▲]

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